Smartphone-assisted Camera-Based Mastoidectomy Training Unit (CBMT): a pilot randomized crossover study of cadaveric temporal bone dissection

Abstract Introduction Temporal bone dissection is a foundational component of otolaryngology surgical training, traditionally performed under operating microscopes that are costly and unavailable in many resource-constrained institutions. We describe and evaluate a novel, low-cost smartphone-based Camera-Based Mastoidectomy Training (CBMT) unit as an adjunct to the operating microscope for temporal bone dissection training. Materials and methods A pilot randomized crossover study was conducted at a tertiary care centre. Fourteen otolaryngology residents with no prior independent cadaveric temporal bone dissection experience participated in a one-day structured workshop. Participants were randomly assigned to one of two equal groups. Each group performed standardized temporal bone dissections using both an operating microscope and the CBMT unit in a crossover fashion on separate fresh cadaveric specimens. Usability was assessed using a 10-item questionnaire on a 5-point Likert scale, analysed using the Wilcoxon signed-rank test. Results The CBMT unit scored significantly higher ( p < 0.05) than the operating microscope for comfort ( r = 0.57), ease of unit adjustment ( r = 0.71), three-dimensional clarity ( r = 0.71), magnification adjustment ( r = 0.77), illumination adjustment ( r = 0.86), ease of mentoring ( r = 0.66), and mobility ( r = 0.86). No significant differences were observed for confidence, hand-eye coordination, or ocular strain. Conclusion In this pilot study, the CBMT unit demonstrated favourable usability, ergonomic characteristics, and teaching facilitation compared to conventional operating microscopes. These preliminary findings suggest that the CBMT unit may be a feasible and acceptable low-cost adjunct for temporal bone dissection training, particularly in resource-limited settings. Larger multicentre studies incorporating objective performance metrics are required before broader adoption.